Prostate Cancer -

May 18, 2010 17:57 ET Robotic Surgery Expert Dr. David Samadi, MD Discusses Robotic-Assisted Laparoscopic Prostatectomy (RALP)

NEW YORK, NY--(Marketwire - May 18, 2010) -  Robotic-Assisted Laparoscopic Prostatectomy (RALP) is fast becoming a common treatment for prostate cancer. "Simply put, RALP can effectively cure cancer and preserve quality of life when it comes to sexual function and continence," said Dr. David B. Samadi, Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York. However, many myths exist about RALP that leave many men hesitant to consider this prostate cancer treatment option.

"This is completely understandable," says Dr. Samadi, "because the learning curve is steep and surgeons need to perform a high volume of cases to really become proficient. Still, despite its many advantages, many patients are hesitant to undergo this procedure. One reason is that patients fear undergoing a surgery that is controlled by a machine." To which Dr. Samadi responds, "It is not the robot doing the surgery; it is the surgeon controlling the robot 100 percent."

The major benefits of RALP include an increased chance of curing the prostate cancer, maintaining urinary continence and preserving sexual function. The surgical advantages include smaller incisions and better magnification for viewing by the surgeon of the prostate and surrounding nerve bundles, which are responsible for continence and sexual function. Decreased instance of blood loss along with a faster physical recovery after surgery are added benefits to this minimally invasive procedure.

Still, it is the fear of surgery that dissuades patients from a RALP. "This anxiety and fear understandably leads patients to pursue other less-invasive treatments," said Dr. Samadi. Currently, between 70 and 80 percent of prostatectomies in the United States are done robotically and those numbers are growing. "Those patients who do not hesitate to get the robotic surgery simply want the cancer out, they don't want it in their bodies," explained Samadi. "RALP ensures total elimination of the cancer, by completely removing the prostate gland, which is the number one goal in prostate cancer treatment."

Of course, as with any surgery there are inherent risks with RALP, including that a patient may not being a viable candidate due to health reasons. Men with very large prostates or those with a history of tumors, high risk of lymph node metastases, or previous pelvic or abdominal surgery are more suited for traditional open surgery. But these cases are very rare, and most men fare very well with RALP.

Dr. Samadi sheds light on little-known emerging facts of the RALP procedure:

  • Low-risk prostate cancer patients who opt for active surveillance may actually benefit from a RALP due to the fact that accurate upgrading and upstaging is ascertained.
  • RALP may be a better option for obese patients or those with a high body mass index (BMI), according to a Mount Sinai study that found that obese patients undergoing RALP had similar outcomes to those of their non-obese counterparts.
  • Having an MRI before RALP helps surgeons make better decisions with regards to the aggressiveness of nerve sparing surgical technique without compromising the oncological outcome.

Dr. Samadi, who has successfully performed over 3,000 RALP procedures, believes that since RALP is challenging and complex, it should be done only in the "hands of experienced surgeons." Samadi, who is trained in open urologic, oncology, and laparoscopic prostatectomy, believes that surgical volume and consistency are critical for a successful RALP outcome. Samadi himself relies on the support of Mount Sinai, a medical center of excellence, as well as his highly skilled surgical team, which contribute to superior surgical outcomes. "The technology alone is never enough," says Samadi.

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